Because of that, Angus says, clinicians and researchers have been passionate about doing something about septic shock. But they have vehemently disagreed on what should be done to correctly manage the condition when patients show up in the emergency department.
"Some people have said you can't possibly believe the Rivers study until it's been validated in a multicenter study, and until then we just have to put the brakes on. While others say [the Rivers study] is far too important of a study. We just have to move ahead, because these people are gravely ill; their [lives are] at stake," Angus says.
The ProCESS report is published in the March 18 online issue of the New England Journal of Medicine in conjunction with Angus's presentation of its results at the International Symposium on Intensive Care and Emergency Medicine in Brussels Tuesday.
The protocol it examines was developed a decade ago by Emanuel Rivers, MD, senior staff attending physician in the surgical critical care unit and emergency department at Henry Ford Hospital in Detroit, who had tested his theory there. His protocol—he is listed as the measure steward—was endorsed and validated by the National Quality Forum in October, 2012.